Banstola D. Effect of Yoga Breathing Exercises...

| Original Article

Effect of Yoga Breathing

Exercises on Ventilatory Function
Banstola D1*
1
Associate professor, Physiology Department
Institute of Medicine, Maharajgunj, Kathmandu, Nepal

ABSTRACT
Introduction: Controlled breathing not only keeps your mind and
body functioning at their best, it can also lower blood pressure,
promote feelings of calm and relaxation and help you de-stress. Many
experts encourage using the yoga breathing exercises as a means of
increasing awareness, mindfulness and reducing anxiety. Over-worked,
under-slept, and feeling pressure may impair breathing pattern. There
are some yoga breathing exercise techniques that improve ventilatory
function.
Objective: To assess the effect of yoga breathing exercises on their
ventilatory function.
Methods: Forty eight male and female students of 18 - 30 years were
involved in the study of ventilatory function before and after yoga
breathing exercise. Pulmonary function tests were performed with the
Keywords
subject sitting in a comfortable chair. Initial recording of tidal volume,
Yoga, Breathing exercise,
Ventilatory function. inspiratory capacity, inspiratory reserve volume, expiratory reserve
volume, forced vital capacity, and timed vital capacity in one second
Corresponding author were measured.
Dinesh Banstola, Associate professor
Results: There was significant increase in inspiratory reserve volume,
Physiology Department
Institute of Medicine, Maharajgunj, expiratory reserve volume, vital capacity, forced expiratory volume in
Kathmandu, Nepal one second and forced vital capacity after yoga breathing exercise.
Email: dinesh_banstola@hotmail.com
Conclusion: Yoga breathing exercise improves ventilatory function.

INTRODUCTION chemical feedback mechanisms can be affected by

Controlled breathing not only keeps your mind and body
functioning at their best, it can also lower blood pressure,
promote feelings of calm and relaxation and help you de-
stress. Many experts encourage using the yoga breathing
exercises as a means of increasing awareness, mindfulness
and reducing anxiety. Over-worked, under-slept, and
feeling pressure may impair breathing pattern. There are
some yoga breathing exercise techniques that improve
ventilatory function1-4.
Breathing is synonymous with being alive. Correct
breathing leads to proper ventilation and oxygenation5-9.
Breathing even though finely controlled by neural and
many ways e.g. stress, anxiety, panic states, abdominal
and thoracic trauma and surgery apart from diseases
of respiratory system10-15. Breathing exercise is used
widely in clinical medicine as one of the methods of
physiotherapy. It is also used in everyday life as a part of
relaxation technique to alleviate stress and to regularize
breathing pattern.
Certain guided breathing exercises are being used like
yoga, pranayama and chants are advocated to improve
pulmonary function. Respiratory muscles strengthening
were tried using music therapy exercise. Effects of
meditation and mental chanting of “OM” on certain

J-GMC-N | Volume 09 | Issue 02 | July-December 2016 page 17

 Original Article | Journal of Gandaki Medical College-Nepal
physiolological parameters has been studied by several
workers. These studies show increased alertness,
autonomic changes, physical relaxation, changes in oxygen
consumption, and basal metabolic rate. Large number
of literature is available on the effects of music therapy.
Listening to specific “ragas” is said to improve health,
bring down elevated blood pressure, relieve headache
and abdominal pain. No extensive study has gone into the
mechanism of such therapy benefits.
Effect of yoga breathing exercises on their ventilatory
function has not been so far studied. The present
investigation was to assess the certain pulmonary
functions before and after yoga breathing exercise in
young male and female students.
OBJECTIVE
To assess the effect of yoga breathing exercises on their
ventilatory function.
METHODS
Forty eight students were involved in the study of
ventilatory function before and after yoga breathing
exercise. Both male and female students were involved.
The students were within 18 to 30 year age groups.
Inclusion criteria
1. Subjects 18 - 30 years without respiratory problems
2. Non-smokers
3. Subjects without history of chronic cardiovascular
disease
4. Subjects without history of allergy that affects
breathing
Exclusion criteria
1. Subjects with upper respiratory tract infections and
any sort of other respiratory disorders
2. Subjects with smoking habits
3. Subjects with history of chronic cardiovascular
disease
4. Subjects with history of allergy that affects breathing
All tests were done at the same time of the day to avoid
possible diurnal variation. Informed consent was obtained
from each volunteered student for this study.
Pulmonary function tests were performed in Knipping-
open spirometer C.F. Palmer Ltd, London, England. Before
each test the subject was familiarized with the instrument
page 18 J-GMC-N | Volume 09 | Issue 02 | July-December 2016
and a detailed instruction cum demonstration upto the
satisfaction was given. All the procedures were carried out
in the postgraduate laboratory, Physiology Department,
IOM.
During the test, the subjects were adequately encouraged
to perform at their optimum level. The forced respiratory
maneuvers were repeated at least five times and the
highest values were considered for the analysis.
Pulmonary function tests were performed with the
subject sitting in a comfortable chair. After reassurance,
the procedure was explained. Initial measurement of tidal
volume (TV), inspiratory capacity (IC), inspiratory reserve
volume (IRV), expiratory reserve volume (ERV), forced
vital capacity (FVC) and timed vital capacity in one second
(FEV1) measured. Breaths interrupted by swallowing or
coughing were identified and discarded.
Spirometry is a procedure that measures the volume
of air an individual inhales or exhales as a function of
time1-11. The measurement was performed with the
subject in an upright position, usually seated. Procedure
was demonstrated till subjects were clear regarding the
technique. Subjects were given instruction to loosen their
clothes that might restrict the movement of the chest and
upper abdomen.
Yoga breathing exercises session
After initial recording of the above tests, the yoga
breathing exercise was administered at morning time, in
small groups of six to eight people. All subjects were put
through daily practice of “yoga breathing exercise” for one
hour each day for 60 days.
Method 1: Bhastrika pranayam: Bellows breath
1. Breathe in deeply through your nostrils. First,
feel the diaphragm move down, allowing the lungs to
expand and forcing the abdomen out; then feel your
chest expand with your collar bones rising last.
2. Breath out quickly through your nostrils. Feel your
collar bones dropping, chest deflating, and abdomen
shrinking as the lungs collapse. This process of
exhaling should be much faster than the process of
inhaling - almost like a rapid deflation.
3. Repeat the process. When correctly done, your chest
will expand when you breathe in and deflate when
you breathe out. Continue doing this for five minutes.
4. With practice, speed up your breathing. Beginners
should always start slowly to avoid hyperventilating,
but over time, it will be possible to turn this into a
rapid breathing technique.
 Banstola D. Effect of Yoga Breathing Exercises... | Original Article
Method 2: Kapalbhati pranayam: Shining forehead
breath
1. Inhale through your nostrils normally until
your lungs are full. Keep your inhalation slow but
unforced. First, feel the diaphragm move down,
allowing the lungs to expand and forcing the
abdomen out; then feel your chest expand with your
collar bones rising last.
2. Exhale through both nostrils forcefully. This places
the emphasis of the breath on the exhale rather than
the (natural) inhale. Assist your exhalation by pulling
in your stomach muscles to expel air. Exhaling should
take much less time than it took to inhale.
Ÿ “Forced” exhalation means that the contraction
of your stomach muscles helps push the air out of
your body. It does not mean that the exhalation
should be uncomfortable for you in any way
3. Repeat breaths for 15 minutes. You may take a
minute rest after every five minutes.
Method 3: Anulom vilom pranayam: Alternate nostril
breath
1. Close your eyes. Focus your attention on your
breathing.
2. Close the right nostril with the right thumb.
Simply press the thumb against your nostril to block
it.
3. Inhale slowly through the left nostril. Fill your
lungs with air. First, feel the diaphragm move
down, allowing the lungs to expand and forcing the
abdomen out; then feel your chest expand with your
collar bones rising last.
4. Remove your thumb from your right nostril. Keep
your right hand by your nose and your lungs full of
air.
5. Use your ring and middle finger to close your left
nostril. Most people find it easier to continue using
the same hand to block either nostril, but you’re
welcome to switch hands depending on which nostril
you’re blocking. You can also switch if your arm gets
tired
6. Exhale slowly and completely with the right
nostril. Feel the collar bones dropping, chest
deflating, and abdomen shrinking as the lungs
collapse. When you’ve finished exhaling, keep your
left nostril closed.
7. Inhale through the right nostril. Fill your lungs.
J-GMC-N | Volume 09 | Issue 02 | July-December 2016
8. Close the right nostril and open the left.
9. Breathe out slowly through the left nostril. This
process is one round of anulom vilom pranayam.
10. Continue for 15 minutes. You may take a minute’s
rest after every five minutes of exercise.
Method 4: Bahya pranayam: External breath
1. Inhale deeply through your nose. First, feel the
diaphragm move down, allowing the lungs to expand
and forcing the abdomen out; then feel your chest
expand with your collar bones rising last.
2. Exhale forcefully. Use your stomach and diaphragm
to push the air from your body. “Forced” exhalation
means that the contraction of your stomach muscles
helps push the air out of your body. It does not mean
that the exhalation should be uncomfortable for you
in any way.
3. Touch your chin to your chest and suck in your
stomach completely. The goal is to leave a hollow
below your ribcage, making it look like the front
muscle wall of your abdomen is pressed against the
back. Hold this position -- and your breath -- for as
long as is comfortable.
4. Lift your chin and breathe in slowly. Allow your
lungs to completely fill with air.
5. Repeat three to five times.
Method 5: Bhramari pranayam: Bee breath
1. Close your eyes. Focus on your breathing.
2. Place your thumbs in your ears, your index
fingers above your eyebrows, and remaining
fingers along the sides of your nose. Keep each
pinky finger near a nostril.
3. Breath in deeply through the nose. First, feel the
diaphragm move down, allowing the lungs to expand
and forcing the abdomen out; then feel your chest
expand with your collar bones rising last.
4. Use your pinkies to partially close each nostril.
Keep your lungs filled.
5. Breathe out through the nose while humming.
Note that the humming sound should originate in
your throat, not as a result of your partially-blocked
nostrils.
6. Repeat three times.
Method 6: Udgeeth pranayam: Chanting breath
1. Breathe in deeply through the nose. First, feel the
diaphragm move down, allowing the lungs to expand
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 Original Article | Journal of Gandaki Medical College-Nepal

and forcing the abdomen out; then feel your chest
expand with your collar bones rising last
2. Exhale very slowly while saying Om. Allow the
syllable to draw out as slowly as you can. Make sure
to keep the 'O' long and the 'M' short. (“OOOOOOm.”)
3. Repeat three times.
ml but after yoga breathing exercise it decreased up to
499 ml which was statistically insignificant (p>0.05).
Mean inspiratory reserve volume of total subjects was
1549 ml before exercise but after exercise it increased up
to 1704 ml. Increment of inspiratory reserve volume was
statistically significant (p<0.05).

All the lung volume and capacities were estimated for
the entire group of students after 15 days of breathing
exercise session. The mean values of guided breathing
exercises were compared with the mean values of the
same parameters after breathing exercise using paired
“t” test. P values of <0.05 was considered significant. Each
subject acted as his own control.
Results were tabulated. Age, height and weight of each
subject were recorded and body surface area was
calculated.
RESULTS
Forty eight students were involved in the study. The mean
age of subject was 21.05 years. The mean height was 1.61
meters. The mean weight of students was 57.3 kg. The
mean body surface area was 1.61 sq meter.
The mean value of inspiratory capacity before exercise
was 2056 ml but after yoga breathing exercise it increased
up to 2183 ml which was statistically significant.
The mean expiratory reserve volume of total subjects was
1281 ml before exercise but after exercise it increased
upto 1450 ml. The increment was statistically significant
(p<0.05).
The mean value of vital capacity before exercise was 2973
ml but after yoga breathing exercise it increased up to
3280 ml. The increments and p-value are significant.
The mean forced vital capacity of total subjects was 3007
ml before yoga breathing exercise but after yoga breathing
exercise it increased up to 3219 ml.
The mean expiratory volume in one second was 2398
ml before exercise but after yoga breathing exercise it
increased up to 2659 ml which is highly significant.

The values of the lung volume, capacities and percentage The mean value of percentage of FEV1 was 80% before
of FEV1/FVC parameters measured in subject before and yoga breathing exercise it increased upto 82%. The values
after yoga breathing exercise depicted in Table 1. are however statistically non-significant.

Table 1: Parameters of lung volume, capacities, FEV1

and percentage of FEV1/FVC DISCUSSION
S Param- Yoga was practiced since more than one thousand years
Test Mean SD ± SE t value p value
No eter in Indian subcontinent. It consists of exercise of different
1 Pre test IRV 1549.47 454.5 ± 65.6 4.97 0.0001* body parts. Breathing exercises are one of them. Yoga is
Post test 1704.34 490.5 ± 62.8
considered to be a very good exercise for maintaining
2 Pre test ERV 1281.25 391.8 ± 56.5 3.5 0.004* proper health and also has a profound effect on the lung
Post test 1450.62 461 ± 73.8
function of an individual. It is claimed that yogic practices
3 Pre test TV 505.72 145.4 ± 20.9 -0.91 0.224
Post test 499.06 125.8 ± 27.4 help in prevention, control and rehabilitation of many
4 Pre test IC 2056.25 507.5 ± 73.2 3.14 0.005*
respiratory diseases. Yoga breathing exercise increases
Post test 2183.83 573.7 ± 95.3 compliance of lungs and thorax, airway resistance and
5 Pre test VC 2973.95 683.2 ± 98.6 3.56 0.003* strength of respiratory muscles16-20.
Post test 3280.98 721.6 ± 104.7
Some researchers like Vinayak P, Doijad et al16, Makwana
6 Pre test FVC 3007.39 633.4 ± 91.4 2.99 0.006*
K et al17, Joshi LN et al18, Yadav RK et al19 and Sodhi C et al20
Post test 3219.91 718.3 ± 105.6
had carried out study on effect of yoga breathing exercise
7 Pre test FEV1 2398.60 710.7 ± 102.5 3.28 0.001*
Post test 2659.84 716.6 ± 105.7 on pulmonary or ventilatory functions and they all
8 Pre test % of 80.21 14.7 ± 2.1 0.98 0.248 observed that following yoga breathing practice there was
Post test FEV1 / 83.19 12.389 ± 1.6 significant improvement in forced vital capacity (FVC) and
FVC timed vital capacity in one second (FEV1) but there was
*p value significance as it is <0.05 no significant change in tidal volume (TV) and percentage
The mean value of tidal volume before exercise was 505.7 of timed vital capacity in one second (%FEV1)16-20. This

page 20 J-GMC-N | Volume 09 | Issue 02 | July-December 2016

 Banstola D. Effect of Yoga Breathing Exercises... | Original Article
finding is similar to present study result.
Tidal volume
During quiet breathing, expiration is a passive process and
is brought about by relaxation of the inspiratory muscles
and lung recoil. Since contraction of the inspiratory
muscles increases the size of the thoracic cage, relaxation
of the same muscles decreases the size of the thoracic
cage to the original. That is enough to generate positive
pressure in the lungs to expel the normal tidal volume.
Spirometric measurement of tidal volume varies from
breath to breath.
Tidal volume was found to be less after yoga breathing
exercises. The mean value of tidal volume before exercise
was 505.7 ml but after yoga breathing exercise it decreased
up to 499 ml which was statistically insignificant (p>0.05).
Inspiratory reserve volume and inspiratory capacity
Inspiratory reserve volume and inspiratory capacity
depend upon the use of accessory muscles of respiration.
These forced breathing maneuvers depend on the
strength of inspiratory muscles. These muscles have to be
used to their maximum capacity to inhale the inspiratory
reserve volumes.
Mean inspiratory reserve volume of total subjects was
1549 ml before exercise but after exercise it increased up
to 1704 ml. Increment of inspiratory reserve volume was
statistically significant (p<0.05).
The mean value of inspiratory capacity before exercise was
2056 ml but after yoga breathing exercise it increased up
to 2183 ml which was statistically significant. Better use
of inspiratory muscles following yoga breathing exercise
may be the reason for the increase in inspiratory reserve
volume and inspiratory capacity.
Expiratory reserve volume
Expiratory muscles have to be used to their maximum
capacity to expel the expiratory reserve volume. During
forceful expiration abdominal muscles play an important
role augmenting the expiratory pressure.
The mean expiratory reserve volume of total subject was
1281ml before exercise but after exercise it increased
upto 1450 ml. The increment was statistically significant
(p<0.05).
Better use of the expiratory muscles following yoga
breathing exercise may be the reason for the increase in
expiratory reserve volume. Decreased airway resistance
may be indirectly contributing in the increase to
expiratory reserve volume.
J-GMC-N | Volume 09 | Issue 02 | July-December 2016
Vital capacity
Vital capacity depends on the strength of respiratory
muscles compliance of lung and chest wall, airway
resistance, integrity of pleura and thoracic structures.
The mean value of vital capacity before exercise was
2973 ml but after yoga breathing exercise it increased up
to 3280 ml. The increments and p-value are significant.
Yoga breathing exercises have resulted in increased
values of vital capacity and forced vital capacity. This
can be explained by better use of respiratory muscles,
greater compliance and mobility of chest wall structures
or decreased airway resistance following yoga breathing
exercise.
Forced vital capacity and forced expiratory volume in
one second
The mean forced vital capacity of total subjects was 3007
ml before yoga breathing exercise but after yoga breathing
exercise it increased up to 3219 ml.
The mean expiratory volume in one second was 2398
ml before exercise but after yoga breathing exercise
it increased up to 2659 ml which is highly significant.
FEV1 depends on the airway resistance. It is a test to
differentiate obstructive lung disease and restrictive lung
disease. Increased FEV1 may be due to lesser airway
resistance after yoga breathing exercise.
The percentage of FEV1
The mean value of percentage of FEV1 was 80% before
yoga breathing exercise, and it increased up to 83%. The
values are however statistically non-significant.
Some researchers claim effectiveness of yoga therapy,
which may include improved pulmonary function,
muscle relaxation, reduced anxiety levels. Yoga breathing
exercises may be a better therapeutic modality since the
present study revealed improved ventilatory function
following yoga breathing exercises. This was evident from
the increase in the value of inspiratory reserve volume,
inspiratory capacity, vital capacity, expiratory reserve
volume, forced vital capacity and forced expiratory
volume in one second.
CONCLUSION
In conclusion, yoga breathing exercises are feasible and
can improve lung function. It seems to be beneficial on
respiratory efficiency. Further studies are required to
establish the fact that whether yoga exercises can improve
quality of life by preventing respiratory disorder.
page 21
 Original Article | Journal of Gandaki Medical College-Nepal
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